Provider Demographics
NPI:1417390253
Name:HUH, BRIAN K (DMD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:K
Last Name:HUH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 E FIR AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3862
Mailing Address - Country:US
Mailing Address - Phone:559-226-2722
Mailing Address - Fax:559-226-6989
Practice Address - Street 1:1903 E FIR AVE STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3862
Practice Address - Country:US
Practice Address - Phone:559-226-2722
Practice Address - Fax:559-226-6989
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA637341223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty